Actinomicose Mandibular Crónica. Implicações Anestésicas e Infecciosas: a Propósito de um Caso Clínico

Doente do sexo feminino, 18 anos, raça negra, natural da Guiné-Bissau, com quadro clínico com 8 anos de evolução, de sinais inflamatórios ao nível de ambos os ângulos da mandíbula, com nódulos palpáveis e drenagem espontânea de material aquoso não purulento, após exodontia de molar mandibular. Para diagnóstico definitivo foi colocada indicação para biópsia mandibular sob anestesia geral. Na avaliação pré-operatória destacava-se uma via aérea previsivelmente muito difícil: mallampati IV, micrognátia com abertura da boca muito limitada (1 cm), distância tiromentoniana < 6 cm e mobilidade cervical limitada, pelo que se programou intubação endotraqueal guiada por fibroscopia. Procedeu-se à intubação nasotraqueal guiada por fibroscopia com tubo 7,0 com cuff, sob sedação endovenosa com midazolam e fentanil, sem intercorrências. A apresentação deste caso tem como objectivo realçar as dificuldades inerentes ao diagnóstico de actinomicose com frequente necessidade de procedimentos invasivos, sob anestesia geral, o que condiciona um risco anestésico importante associado à dificuldade na abordagem da via aérea.

Corte, poder e utopia: o relox de príncepes (1529). De Fr. António de Guevara e a sua fortuna na Europa do século XVI

Antonio de Guevara (1480?-1545), es una figura singular de la cultura ibérica del siglo XVI. La proximidad al emperador Carlos V marcará su trayectoria personal y su producción literaria. La publicación, en 1528, del Libro Aureo de Marco Aurelio, dará cominezo a una carrera literaria que hará de Guevara uno de los autores más leidos y apreciados de la Europa del siglo XVI. Procurando inscribir su carrera vital en la coyuntura histórica de la España de su tiempo, este texto analiza l trayectoria y fortuna del Relox de Príncipes, publicado en 1529, y su irradiación ibérica y europea, con especial incidencia para el caso portugués.

On mappings preserving the sharp and star orders

The present paper is devoted to the study of linear maps preserving certain relations, such as the sharp partial order and the star partial order in semisimple Banach algebras and C*-algebras.

GESTIÓN DEL DISEÑO Y LA INNOVACIÓN EN LA RELACIÓN UNIVERSIDAD - ENTRAMADO SOCIO-PRODUCTIVO

PROBLEMA DE INVESTIGACION El problema que aborda la investigación es la falta de transferencia de conocimientos de diseño + innovación (arquitectura, diseño industrial, diseño gráfico, etc.) al sistema socio productivo de la provincia de Córdoba, lo cuál afecta la productividad y la competitividad de las empresas y, por otra parte, dificulta la inserción laboral de los profesionales formados en las universidades del medio. La provincia de Córdoba posee un importante potencial industrial que intenta contrabalancear el predominio de la región metropolitana de Buenos Aires. Las áreas de mayor desarrollo son la automotriz, metal-mecánica, agro-industrial, la construcción y la alimentaría. El diseño correctamente gestionado, constituye una fuente de ventajas comparativas, una eficaz metodología para la innovación de productos y procesos y un factor de rentabilidad económica. Por otro lado, existe una falta de respuesta a problemas relacionados al diseño, (como los aspectos relativos a la calidad de vida, la responsabilidad social y la protección del ambiente, por mencionar algunos) que no son formulados como prioridades cuantitativas en los productos de diseño promovidos por las empresas. En este sentido, las Universidades de la Red, cuentan con instrumentos específicos a nivel de grado y postgrado para promover la interrelación entre Universidad, Empresas y Ongs de la Provincia. La carrera de Diseño Industrial de la Universidad Nacional de Córdoba y la Maestría en Diseño de la Universidad Católica de Córdoba han estado cooperando desde inicios del 2009 en la conformación del Programa Córdoba Diseña del Ministerio de Ciencia y Tecnología de la Provincia de Córdoba, que tiene el objetivo de "desarrollar y orientar las capacidades de análisis, evaluación y asistencia técnica en temas referidos al Diseño, para el gobierno, las empresas, las universidades y centros de investigación". En el marco de ese programa del que las universidades participantes son miembros, existe un diagnóstico incipiente de los requerimientos de las empresas, y de la actividad de los diseñadores en la provincia. Al mismo tiempo, se ve necesario recabar datos sobre los requerimientos de diseño desde el sector de organizaciones no gubernamentales y sin fines de lucro. A los efectos de contar con un relevamiento que posibilite un diagnóstico más preciso, es necesario sistematizar y cruzar los datos que se derivan de: la conformación del entramado socio-productivo de la provincia, la oferta académica y el capital humano que estamos formando en las Universidades. Ambas universidades integrantes de la Red, cuentan con una reconocida trayectoria en el Área de Diseño y con capital humano de diferentes disciplinas (diseño industrial, arquitectura, gestión pública, sociología, etc.) para llevar adelante el proyecto. Los resultados del proyecto servirán para formular un marco teórico específico, fundamentar estrategias de mejoramiento de la calidad académica, delinear propuestas de sistemas asociativos y definición de prioridades de líneas de investigación para mejorar la eficiencia de la relación Universidades-Empresas-Sociedad. Por otra parte, posibilitarán relevar las demandas del medio-socio productivo en términos de la formación profesional requerida, la inserción de los profesionales y la importancia de la innovación en tanto valor agregado a productos y procesos en el entramado socio-productivo de la provincial de Córdoba. OBJETIVOS - Analizar, sistematizar y consolidar información respecto a la experiencia acumulada, las capacidades actuales y las potencialidades en materia de diseño e innovación en Córdoba. - Identificar las empresas del medio productivo local y las organizaciones del tercer sector que demandan profesionales formados en diseño e innovación, e indagar sobre los requerimientos que plantean en términos de competencias y formacion académica. -Identificar los desfasajes que pudieran existir en relación a la demanda que plantea el medio productiv

Sedació intravenosa per procediments endoscòpics digestius: satisfacció dels pacients i perfil de seguretat.

o INTRODUCCIÓN: Las exploraciones endoscópicas digestivas son molestas para el paciente. El objetivo principal del trabajo es evaluar la satisfacción de los pacientes después de la sedación por un anestesiólogo. MATERIAL Y MÉTODO: se seleccionaron 50 pacientes. Se administró una pauta de sedoanalgesia con midazolam, fentanilo y propofol. RESULTADOS: Ningún paciente precisó ventilación manual. La complicación más frecuente al alta fue dolor abdominal. Todos los pacientes valoraron la experiencia como buena o muy buena. CONCLUSIONES: La sedación intravenosa para endoscopias digestivas aumenta la satisfacción de los pacientes, manteniendo un perfil de seguridad adecuado.

Creatividad publicitaria :análisis de los modelos que evalluan la creatividad en los productos publicitarios

Realizar una recopilacion organizada de los conocimientos pertenecientes al tema de valoracion de la creatividad en los productos publicitarios, con la finalidad de hacer un analisis de los metodos utilizados por los investigadores. Esto permite tambien, la construccion de un marco teorico, que servira como fundamento para el desarrollo de un metodo propio en la segunda parte de este estudio, ademas de identificar las futuras lineas de investigacion aplicables al estudio de la creatividad.

Las Imágenes del malestar. Representaciones del yo y la construcción de subjetividad en la producción audiovisual contemporánea y en los nuevos dispositivos tecnológicos

El tema de la investigación propuesto aquí, se centra en el malestar social, y la representación de éste desde un punto de vista personal y autobiográfico, algo que en estas página denomino Autorepresentación del malestar social. ¿Cómo se autorepresenta el malestar y qué prácticas artísticas se emplean para ello? ¿Cuáles son la transformaciones que provocan estas prácticas artísticas en el terreno audiovisual? En este sentido, exploraremos dos vías de análisis: por un lado nos interesa observar cuales han sido las modificaciones que el poder ha desarrollado para establecer nuevas formas de explotación, y por otro lado, veremos como estas modificaciones están generando una nueva praxis social donde las prácticas artísticas cobran un nuevo y reforzado sentido, así como una nueva capacidad política, individual y colectiva a un mismo tiempo, cargada de una fuerza transformadora capaz de componer nuevos espacios de sujeto. Analizaremos, desde la representación del yo en la vida cotidiana, el género y las relaciones interpersonales, hasta las transformaciones contemporáneas del trabajo, y los cambios en la construcción de la subjetividad. El principal elemento en el que se apoyaran nuestras investigaciones será el anàlisis de producciones audiovisuales contemporáneas y la distribución de estas en algunas de las redes de comunicación contemporáneas, intentando mostrar, de esta manera, la interacción y los efectos directos que provocan en la realidad social.

Ampliación y actualización de una empresa de formación, sobre software libre

Este proyecto trata de una investigacion, sobre una migracion de una empresa a software libre.

Late pulmonary metastases of renal cell carcinoma immediatelyafter post-transplantation immunosuppressive treatment: a case report

INTRODUCTION We report a case of pulmonary metastatic recurrence of renal adenocarcinoma soon after radical nephrectomy that was followed by renal transplant and immunosuppressive medication. Increased risk of metastatic recurrence of renal cell carcinoma should be considered in the immediate post-transplant period when immunosuppressive medication is administered, even if nephrectomy had been performed many years earlier. CASE PRESENTATION In 1986 the patient demonstrated renal insufficiency secondary to mesangial glomerulonephritis. In 1992 he underwent left side radical nephrectomy with histopathological diagnosis of clear cell adenocarcinoma. Mesangial glomerulonephritis in the remaining right kidney progressed to end-stage renal failure. In October 2000 he received a kidney transplant from a cadaver and commenced immunosuppressive medication. Two months later, several nodules were found in his lungs, which were identified as metastases from the primary renal tumor that had been removed with the diseased kidney 8 years earlier. CONCLUSION Recurrence of renal cell carcinoma metastases points to tumor dormancy and reflects a misbalance between effective tumor immune surveillance and immune escape. This case demonstrates that a state of tumor dormancy can be interrupted soon after administration of immunosuppressant medication.

Distinct mechanisms of loss of IFN-gamma mediated HLA class I inducibility in two melanoma cell lines

BACKGROUND The inability of cancer cells to present antigen on the cell surface via MHC class I molecules is one of the mechanisms by which tumor cells evade anti-tumor immunity. Alterations of Jak-STAT components of interferon (IFN)-mediated signaling can contribute to the mechanism of cell resistance to IFN, leading to lack of MHC class I inducibility. Hence, the identification of IFN-gamma-resistant tumors may have prognostic and/or therapeutic relevance. In the present study, we investigated a mechanism of MHC class I inducibility in response to IFN-gamma treatment in human melanoma cell lines. METHODS Basal and IFN-induced expression of HLA class I antigens was analyzed by means of indirect immunofluorescence flow cytometry, Western Blot, RT-PCR, and quantitative real-time RT-PCR (TaqMan(R) Gene Expression Assays). In demethylation studies cells were cultured with 5-aza-2'-deoxycytidine. Electrophoretic Mobility Shift Assay (EMSA) was used to assay whether IRF-1 promoter binding activity is induced in IFN-gamma-treated cells. RESULTS Altered IFN-gamma mediated HLA-class I induction was observed in two melanoma cells lines (ESTDAB-004 and ESTDAB-159) out of 57 studied, while treatment of these two cell lines with IFN-alpha led to normal induction of HLA class I antigen expression. Examination of STAT-1 in ESTDAB-004 after IFN-gamma treatment demonstrated that the STAT-1 protein was expressed but not phosphorylated. Interestingly, IFN-alpha treatment induced normal STAT-1 phosphorylation and HLA class I expression. In contrast, the absence of response to IFN-gamma in ESTDAB-159 was found to be associated with alterations in downstream components of the IFN-gamma signaling pathway. CONCLUSION We observed two distinct mechanisms of loss of IFN-gamma inducibility of HLA class I antigens in two melanoma cell lines. Our findings suggest that loss of HLA class I induction in ESTDAB-004 cells results from a defect in the earliest steps of the IFN-gamma signaling pathway due to absence of STAT-1 tyrosine-phosphorylation, while absence of IFN-gamma-mediated HLA class I expression in ESTDAB-159 cells is due to epigenetic blocking of IFN-regulatory factor 1 (IRF-1) transactivation.

Genetic polymorphisms of RANTES, IL1-A, MCP-1 and TNF-A genes in patients with prostate cancer

BACKGROUND Inflammation has been implicated as an etiological factor in several human cancers, including prostate cancer. Allelic variants of the genes involved in inflammatory pathways are logical candidates as genetic determinants of prostate cancer risk. The purpose of this study was to investigate whether single nucleotide polymorphisms of genes that lead to increased levels of pro-inflammatory cytokines and chemokines are associated with an increased prostate cancer risk. METHODS A case-control study design was used to test the association between prostate cancer risk and the polymorphisms TNF-A-308 A/G (rs 1800629), RANTES-403 G/A (rs 2107538), IL1-A-889 C/T (rs 1800587) and MCP-1 2518 G/A (rs 1024611) in 296 patients diagnosed with prostate cancer and in 311 healthy controls from the same area. RESULTS Diagnosis of prostate cancer was significantly associated with TNF-A GA + AA genotype (OR, 1.61; 95% CI, 1.09-2.64) and RANTES GA + AA genotype (OR, 1.44; 95% CI, 1.09-2.38). A alleles in TNF-A and RANTES influenced prostate cancer susceptibility and acted independently of each other in these subjects. No epistatic effect was found for the combination of different polymorphisms studied. Finally, no overall association was found between prostate cancer risk and IL1-A or MCP-1 polymorphisms. CONCLUSION Our results and previously published findings on genes associated with innate immunity support the hypothesis that polymorphisms in proinflammatory genes may be important in prostate cancer development.

Lipoprotein lipase activity and mass, apolipoprotein C-II mass and polymorphisms of apolipoproteins E and A5 in subjects with prior acute hypertriglyceridaemic pancreatitis

BACKGROUND Severe hypertriglyceridaemia due to chylomicronemia may trigger an acute pancreatitis. However, the basic underlying mechanism is usually not well understood. We decided to analyze some proteins involved in the catabolism of triglyceride-rich lipoproteins in patients with severe hypertriglyceridaemia. METHODS Twenty-four survivors of acute hypertriglyceridaemic pancreatitis (cases) and 31 patients with severe hypertriglyceridaemia (controls) were included. Clinical and anthropometrical data, chylomicronaemia, lipoprotein profile, postheparin lipoprotein lipase mass and activity, hepatic lipase activity, apolipoprotein C II and CIII mass, apo E and A5 polymorphisms were assessed. RESULTS Only five cases were found to have LPL mass and activity deficiency, all of them thin and having the first episode in childhood. No cases had apolipoprotein CII deficiency. No significant differences were found between the non-deficient LPL cases and the controls in terms of obesity, diabetes, alcohol consumption, drug therapy, gender distribution, evidence of fasting chylomicronaemia, lipid levels, LPL activity and mass, hepatic lipase activity, CII and CIII mass or apo E polymorphisms. However, the SNP S19W of apo A5 tended to be more prevalent in cases than controls (40% vs. 23%, NS). CONCLUSION Primary defects in LPL and C-II are rare in survivors of acute hypertriglyceridaemic pancreatitis; lipase activity measurements should be restricted to those having their first episode during childhood.

Drugs Associated with Hepatotoxicity and their Reporting Frequency of Liver Adverse Events in VigiBase (TM) Unified List Based on International Collaborative Work

BACKGROUND Challenges exist in the clinical diagnosis of drug-induced liver injury (DILI) and in obtaining information on hepatotoxicity in humans. OBJECTIVE (i) To develop a unified list that combines drugs incriminated in well vetted or adjudicated DILI cases from many recognized sources and drugs that have been subjected to serious regulatory actions due to hepatotoxicity; and (ii) to supplement the drug list with data on reporting frequencies of liver events in the WHO individual case safety report database (VigiBase). DATA SOURCES AND EXTRACTION (i) Drugs identified as causes of DILI at three major DILI registries; (ii) drugs identified as causes of drug-induced acute liver failure (ALF) in six different data sources, including major ALF registries and previously published ALF studies; and (iii) drugs identified as being subjected to serious governmental regulatory actions due to their hepatotoxicity in Europe or the US were collected. The reporting frequency of adverse events was determined using VigiBase, computed as Empirical Bayes Geometric Mean (EBGM) with 90% confidence interval for two customized terms, 'overall liver injury' and 'ALF'. EBGM of >or=2 was considered a disproportional increase in reporting frequency. The identified drugs were then characterized in terms of regional divergence, published case reports, serious regulatory actions, and reporting frequency of 'overall liver injury' and 'ALF' calculated from VigiBase. DATA SYNTHESIS After excluding herbs, supplements and alternative medicines, a total of 385 individual drugs were identified; 319 drugs were identified in the three DILI registries, 107 from the six ALF registries (or studies) and 47 drugs that were subjected to suspension or withdrawal in the US or Europe due to their hepatotoxicity. The identified drugs varied significantly between Spain, the US and Sweden. Of the 319 drugs identified in the DILI registries of adjudicated cases, 93.4% were found in published case reports, 1.9% were suspended or withdrawn due to hepatotoxicity and 25.7% were also identified in the ALF registries/studies. In VigiBase, 30.4% of the 319 drugs were associated with disproportionally higher reporting frequency of 'overall liver injury' and 83.1% were associated with at least one reported case of ALF. CONCLUSIONS This newly developed list of drugs associated with hepatotoxicity and the multifaceted analysis on hepatotoxicity will aid in causality assessment and clinical diagnosis of DILI and will provide a basis for further characterization of hepatotoxicity.

FABP4 Dynamics in Obesity: Discrepancies in Adipose Tissue and Liver Expression Regarding Circulating Plasma Levels.

BACKGROUND FABP4 is predominantly expressed in adipose tissue, and its circulating levels are linked with obesity and a poor atherogenic profile. OBJECTIVE In patients with a wide BMI range, we analyze FABP4 expression in adipose and hepatic tissues in the settings of obesity and insulin resistance. Associations between FABP4 expression in adipose tissue and the FABP4 plasma level as well as the main adipogenic and lipolytic genes expressed in adipose tissue were also analyzed. METHODS The expression of several lipogenic, lipolytic, PPAR family and FABP family genes was analyzed by real time PCR. FABP4 protein expression in total adipose tissues and its fractions were determined by western blot. RESULTS In obesity FABP4 expression was down-regulated (at both mRNA and protein levels), with its levels mainly predicted by ATGL and inversely by the HOMA-IR index. The BMI appeared as the only determinant of the FABP4 variation in both adipose tissue depots. FABP4 plasma levels showed a significant progressive increase according to BMI but no association was detected between FABP4 circulating levels and SAT or VAT FABP4 gene expression. The gene expression of FABP1, FABP4 and FABP5 in hepatic tissue was significantly higher in tissue from the obese IR patients compared to the non-IR group. CONCLUSION The inverse pattern in FABP4 expression between adipose and hepatic tissue observed in morbid obese patients, regarding the IR context, suggests that both tissues may act in a balanced manner. These differences may help us to understand the discrepancies between circulating plasma levels and adipose tissue expression in obesity.

Tumor necrosis-like weak inducer of apoptosis as a proinflammatory cytokine in human adipocyte cells: up-regulation in severe obesity is mediated by inflammation but not hypoxia.

CONTEXT Adipose tissue hypoxia and endoplasmic reticulum (ER) stress may link the presence of chronic inflammation and macrophage infiltration in severely obese subjects. We previously reported the up-regulation of TNF-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible 14 (Fn14) axis in adipose tissue of severely obese type 2 diabetic subjects. OBJECTIVES The objective of the study was to examine TWEAK and Fn14 adipose tissue expression in obesity, severe obesity, and type 2 diabetes in relation to hypoxia and ER stress. DESIGN In the obesity study, 19 lean, 28 overweight, and 15 obese nondiabetic subjects were studied. In the severe obesity study, 23 severely obese and 35 control subjects were studied. In the type 2 diabetes study, 11 type 2 diabetic and 36 control subjects were studied. The expression levels of the following genes were analyzed in paired samples of sc and visceral adipose tissue: Fn14, TWEAK, VISFATIN, HYOU1, FIAF, HIF-1a, VEGF, GLUT-1, GRP78, and XBP-1. The effect of hypoxia, inflammation, and ER stress on the expression of TWEAK and Fn14 was examined in human adipocyte and macrophage cell lines. RESULTS Up-regulation of TWEAK/Fn14 and hypoxia and ER stress surrogate gene expression was observed in sc and visceral adipose tissue only in our severely obese cohort. Hypoxia modulates TWEAK or Fn14 expression in neither adipocytes nor macrophages. On the contrary, inflammation up-regulated TWEAK in macrophages and Fn14 expression in adipocytes. Moreover, TWEAK had a proinflammatory effect in adipocytes mediated by the nuclear factor-kappaB and ERK but not JNK signaling pathways. CONCLUSIONS Our data suggest that TWEAK acts as a pro-inflammatory cytokine in the adipose tissue and that inflammation, but not hypoxia, may be behind its up-regulation in severe obesity.